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Measurement of perceptions of educational environment in evidence-based medicine
  1. Anne-Marie Bergh1,
  2. Jackie Grimbeek1,
  3. Win May2,
  4. A Metin Gülmezoglu3,
  5. Khalid S Khan4,
  6. Regina Kulier3,
  7. Robert C Pattinson1
  1. 1Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa
  2. 2Department of Medical Education, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  3. 3World Health Organization, Geneva, Switzerland
  4. 4Women's Health Research Unit, The Blizard Institute, Barts and The London School of Medicine, Queen Mary, University of London, London, UK
  1. Correspondence to: Dr Anne-Marie Bergh
    Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Private Bag X323, Arcadia, Pretoria 0007, South Africa; anne-marie.bergh{at}

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Educational environment in medical education can be described as the context in which clinical staff and students teach and learn.1 This environment has also been associated with educational or learning climate2–5 and educational culture.5 According to Genn,4 ,5 climate is a manifestation of the concept of environment. In the past 20 years, several publications have appeared on the measurement of students’ perceptions of various types of medical educational environments. Besides more general descriptions of the medical education environment,4–7 environments have also been delimited to specific situations such as the operating theatre,8–10 general practice training11 and undergraduate12 ,13 and postgraduate3 ,14 ,15 training. An implicit aim of all education in healthcare settings is to produce an environment conducive to advanced and in-service learning.

Measuring students’ or doctors’ perceptions of the medical educational environment has a long history. Some of the older, widely used instruments are the Learning Environment Questionnaire (LEQ) and the Medical School Learning Environment Survey (MSLES).7 According to Schönrock-Adema et al,14 the lack of consensus about which concepts to measure may be explained by the absence of a common theoretical framework. They propose a framework with three broad domains for developing medical educational environment measures: goal orientation (content and aims of education in relation to personal development); relationships (open and friendly atmosphere and affiliation); and organisation/regulation (system maintenance and change). An instrument that has in the past 15 years been applied in a variety of settings across the world and that also caught our attention is the so-called Dundee Ready Education Environment Measure (DREEM).12 The DREEM sparked the development and validation of other tools measuring more specific postgraduate educational environments.8 ,10 ,11 ,15–22

The measurement of the educational environment was …

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